Karen Kwan MD

Family doctor, wife, mom to CMDA Dallas students and residents, tweets are my own

[Kevin Pho, M.D. @kevinmd]

85 to 90 percent of women physicians are eldest daughters.

That is not a coincidence. That is a pipeline.

Eldest daughters are trained, before age five, to over-function. They take on a parent's worry. They organize the family. They clean up without being asked. They do not ask for help, because they were rewarded their whole childhood for not needing any.

Then they walk into medicine.

A career that demands hyper-responsibility, hypervigilance, perfectionism, and silent sacrifice does not have to ask these women to give those things. They were giving them before they could read.

The system is not stumbling into a burnout problem. The system is recruiting from a pool of people whose entire childhood was a training program for it.

This is what pediatrician and certified coach Jessie Mahoney has been finding when she asks the room. In every group, in every retreat. Maybe one or two women are not eldest daughters. The rest have been carrying something since before they could spell their own name.

Most of those women blame themselves. "Why don't I have boundaries?" "Why do I over-function?" "Why can't I delegate?"

Because at five years old, your family rewarded you for over-functioning. Because every teacher praised you for it. Because the medical training system selected for it. Because every job since has reinforced it. The pattern is older than your medical degree by twenty years.

The other piece nobody names: by the time these women are in their fifties, they are carrying eldest-daughter responsibility for aging parents AND running a department as chief AND running a household. The role does not retire when the children do. It just compounds.

Jessie's reframe is the part worth bookmarking.

The "hero" framing is the trap. Eldest daughters were made the savior of the family before they could read. Then medicine made them the savior of the patient. Then the department made them the savior of the team. At every stage, they learned that if they did not do it, terrible things would happen and it would be their fault.

Awareness is the first move. Non-judgment is the second. Excellence is not doing everything yourself. Excellence is letting other people do their jobs.

You are allowed to gift some of it back. You can ask your siblings to carry the aging parent. You can let your medical assistant do the medical assistant's job. You can stop covering the gap that nobody actually asked you to cover.

Most eldest daughters in medicine have never asked for help. When they finally do, they discover people are willing to help. The asking was the whole obstacle.

Listen to the full conversation on The Podcast by KevinMD. Link in the replies.

What is the one task you have been carrying for your family or your team that no one ever actually asked you to carry?

#ThePodcastbyKevinMD

[Karen Kwan MD @kkwanmd]

Sun Protection 101—Your Guide to Sunscreen https://t.co/hITbpTZqgt

[Kristin M. Collier, MD @HSRdirector]

If you are a medical student who didn’t match today, I’m so so sorry. I can imagine the anguish and anxiety you must be feeling.

please know that while our chosen profession is important, that it shouldn’t define you.

you were created for more than this.

[Kristin M. Collier, MD @HSRdirector]

in Dallas today, exited to give a talk on the Meaning of Medicine at noon at @UTSWMedCenter

the talk is adapted from this in @PublicDiscourse https://t.co/fOabBugU1q

[Karen Kwan MD @kkwanmd]

Remembering Dr. Janelle Goetcheus https://t.co/oPHt48SGaU A life well-lived!

[Karen Kwan MD @kkwanmd]

@JohnCornyn @tedcruz Congress must pass legislation to modernize Medicare physician payment and strengthen access to care for Medicare beneficiaries. I urge you to work with your colleagues to support family physicians & enact long-term solutions to Medicare physician payment!

[Karen Kwan MD @kkwanmd]

@RepEllzey I urge you to co-sponsor @RepMMM, @RepRaulRuizMD, @RepLarryBucshon and @RepBera's Strengthening Medicare for Patients and Providers Act to help create a more sustainable Medicare physician payment system & protect my patients’ access to care!

[Karen Kwan MD @kkwanmd]

Republicans Should Be the Party of Mental Health, Not Marijuana https://t.co/nC4nWVQjXs

[Karen Kwan MD @kkwanmd]

5th annual Dallas conference on Science and Faith coming up! Virtual options available as well if you can’t make it to @DBUPatriots

[Stephen C. Meyer @StephenCMeyer]

Join me in person at Dallas Baptist University Feb 17-18 to explore science & faith and why it matters. Also see Frank Turek, James Tour, Nancy Pearcey, and more & equip yourself with the facts and resources you need to respond to cancel culture in the name of science.

[Karen Kwan MD @kkwanmd]

Really appreciate @inspirelifenow and @rolandcwarren for their work in making disciples and in promoting abundant life for all! ~Life is developed like a photo not constructed like a Tesla!… Can’t wait for part 2!

[Christian Medical & Dental Associations® (CMDA) @CMDANational]

TOMORROW!!!
Register Now for this Free Event and earn continuing 1.5 hours of continuing education credits! https://t.co/E9CYf9hebS

[Karen Kwan MD @kkwanmd]

One of the most difficult topics to grapple with as a Christian physician is the theology of suffering. Love this take on Life in the in-between.

[BibleProject @bibleproject]

Does God curse humans in the Bible? Learn more about God's plan to reverse the curse and bless humans in the blog post "How Does the Bible Explain Suffering?"

Read it here: https://t.co/GcAVOfl2m8

[Karen Kwan MD @kkwanmd]

Do unto others as you would have them do unto you…

[Jeff Warren @Jeff_Warren]

A picture of the Church at her best. In Christ, empathy leads to action. 🙂

[Karen Kwan MD @kkwanmd]

Love being SCF Mom. #mentoringthenextgeneration

[Christian Medical & Dental Associations® (CMDA) @CMDANational]

CMDA Today - Fall 2022 #CMDAToday

READ HERE: https://t.co/3ec7hN0B7o

[Karen Kwan MD @kkwanmd]

Primary Care Docs Need 27 Hours a Day to Do Their Best Work https://t.co/a5JWo5rLUF

[Karen Kwan MD @kkwanmd]

@CTmagazine A time to #grieve #lament #repent

[Christianity Today @CTmagazine]

The SBC Executive Committee confirmed on Friday that the Justice Department “has initiated an investigation into the Southern Baptist Convention, and that the investigation will include multiple SBC entities.”
https://t.co/y9fH9Zshpm

[CMDA Student Life @CMDAStudentLife]

Deadline approaching! If you’re planning on doing an away mission rotation or short-term trip in the coming year, CMDA has scholarships you should apply for! August 1st is the deadline for next round of grants. Check out our scholarship page (https://t.co/kblXJDMJgZ)-apply today!

[Karen Kwan MD @kkwanmd]

So proud of @ConstanceWu for her bravery in sharing her story. AsAms don’t always have to be strong. Vulnerability breeds community and together we can get thru a lot of hard times. #BetterTogether #suicideprevention #truthshallsetyoufree @AAPInNews @asianmhc

[Karen Kwan MD @kkwanmd]

I am so enthralled by this video @LiveAction @CMDANational https://t.co/LeL0Wb9RYv

[Karen Kwan MD @kkwanmd]

A time to #lament and #repent. Thank you @jdgreear At SBC meeting, victims confronting leaders highlights small signs of big cultural change https://t.co/ifGrnP4dOM via @houstonchron